Acceptance of Home-Based Chlamydia Genital and Anorectal Testing Using Short Message Service (SMS) in Previously Tested Young People and Their Social and Sexual Networks

• Published in: PloS one 2015-07, Vol.10 (7), p.e0133575-e0133575
• Main Authors: Dukers-Muijrers, Nicole H T M, Theunissen, Kevin A T M, Wolffs, Petra T, Kok, Gerjo, Hoebe, Christian J P A
• Format: Article
• Language: English
• Subjects: Acceptance tests; Adolescent; Adult; Anorectal; Bacteria; Chlamydia; Chlamydia Infections - diagnosis; Chlamydia Infections - prevention & control; Chlamydia trachomatis; Collection; Environmental health; Female; Health services; Humans; Infections; Infectious diseases; Male; Medical screening; Mens health; Patient Acceptance of Health Care; Peers; Primary care; Public health; Reagent Kits, Diagnostic; Rectal Diseases - diagnosis; Rectal Diseases - microbiology; Rectal Diseases - prevention & control; Risk acceptance; Self Care - psychology; Sex; Sexual Partners; Sexually transmitted diseases; Short message service; Social interactions; Social networks; Social organization; Social Support; STD; Studies; Text Messaging; Urine; Womens health; Young Adult; Young adults
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0133575

Control strategies for Chlamydia trachomatis (CT) are most effective when targeting people at highest risk. We assessed test acceptance of home-collection test kits offered by short messaging services (SMS) texts, in high-risk young people, i.e. those who had previously tested CT positive (positive indices), or negative reporting more than 3 sex partners (negative indices), and their sexual and social networks. Young (16 to 25 years old) heterosexuals who previously tested positive (n=536) or negative (n=536) in our STI clinic received, 3 to 20 months after their initial screening, an SMS inviting them to re-test. They were offered a free home-collection test kit including a genital (men and women) and anorectal (women only) test, and a test kit to pass on to a friend or sex partner (peer). SMS reminders were sent in case of non-response. We assessed proportions of tests requested and returned, peers tested, and positivity. Associations with the individual's initial screening result and other factors were explored using logistic regression. Of 1072 people invited to retest, 34.4% (n=369) requested a test. Of these, 55.8% (n=206) retested. Overall, retest participation was higher in positive (22%) than in negative indices (16%) (p22 years. Positivity was 13% and 7% in positive and negative indices, respectively. One in 3 retesters also had a peer tested. Of tested peers (n=87), 84% were friends, 31% were first-time testers, and 7% tested positive. Acceptance of a relatively low-cost strategy for genital and anorectal testing, i.e. using SMS and home-collection test kits, was highest in individuals who previously tested CT positive suggesting that implementation for this group may be considered. By further including a peer-led testing component, undetected CT positives can be identified in the social networks surrounding a high-risk individual.